thoracic wall exam 3 anatomy

Question 1

what is included in the thoracic skeleton?

Answer 1

12 thoracic vertebrae and IV discs
12 pair of ribs
costal cartilages
sternum

Question 2

describe the throracic articular facets (position and function)

Answer 2

they face anteriorly/posteriorly
rotation
some lateral flexion

Question 3

which part of the rib is most susceptible to a fracture?

Answer 3

angle of the rib

Question 4

what part of ribs protects neurovascular supply?

Answer 4

costal groove

Question 5

what are the 2 atypical ribs?

Answer 5

rib 1
rib 12- floating, not directly attached to costal cartilage

Question 6

what kind of cartilage and joints are the costal cartilages?

Answer 6

-hyaline cartilage
-sternocostal joints (mostly synovial)

Question 7

what structures are palpable at the costal margin?

Answer 7

liver, xyphoid process, gallbladder, maybe a part of the stomach

Question 8

rib classification

Answer 8

true ribs= 1-7
false ribs= 8-10
floating ribs= 11-12

Question 9

rib 2 is involved with what 2 structures of the sternum?

Answer 9

half is w body of sternum and half is w manubirum

Question 10

what joint is the base of the heart at?

Answer 10

xiphisternal joint

Question 11

what anatomical structures are located at sternal angle?

Answer 11

aortic arch, bifercation of trachea

Question 12

what cartilages are at body of sternum?
what procedures are associated with body of sternum?

Answer 12

-costal cartilages 2-7
-sternal biopsy, median sternotomy, sternal rub

Question 13

what part of the sternum can potentially break off and go into the liver?

Answer 13

xiphoid process

Question 14

xiphoid process

Answer 14

-ossifies about 40 years old
-t10 vertebral level
-diaphragm attachment
-xiphisternal joint

Question 15

movements of the thoracic wall

Answer 15

sternum- pendulum movement
ribs- bucket handle mvmt

Question 16

muscles of the thoracic wall

Answer 16

pectoralis major, pectoralis minor, serratus anterior, transverse thoracis, intercostal muscles

Question 17

pectoralis major
origin, action, insertion

Answer 17

-2 heads (clavicular head and sternocostal head)
-insertion= lateral lip of intertubecular groove of humerus
-action=
*adduct and medially rotate humerus
*draws scapula anterior and inferiorly
-isolated action=
*clavicular head flex humerus
*sternocostal head extend humerus

Question 18

innervation of pectoralis major

Answer 18

medial and lateral pectoral nerves *these are branches of the brachial plexus

Question 19

pectoralis minor origin, action, insertion

Answer 19

origin=ribs 3-5
action=stabilize scapula
insertion=coracoid process

Question 20

innervation of pectoralis minor

Answer 20

medial pectoral nerve

“medial does more”

Question 21

origin, action, and insertion of serratus anterior

Answer 21

origin=ribs 1-8/9 and side of chest
action=draws scapula anterior and superior; abducts scapula; scapular rotation and stabilization of vertebral border
insertion= long thoracic nerve

Question 22

origin, action, and insertion of transversus thoracis

Answer 22

origin=costal cartilages of last 3-4 ribs
action=depresses ribs
insertion=ribs and costal cartilages of 2-6

Question 23

what is the innervation of transversus thoracis

Answer 23

intercostal nerves

Question 24

what is the function and innervation of the intercostal muscles?

Answer 24

function= stabilize intercostal spaces during respiration
innervation= intercostal nerves

Question 25

layers of the intercostal muscles

Answer 25

external-elevate ribs during forceful inspiration
internal-depresses ribs during forced expiration
innermost-reduce transverse dimension of thoracic cavity during expiration

Question 26

where are the intercostal nerves coming from?

Answer 26

ventral rami

Question 27

where are the intercostal arteries coming from?

Answer 27

aorta

Question 28

where do intercostal veins drain?

Answer 28

azygos system

Question 29

subcostal nerve

Answer 29

T12

Question 30

intercostal nerve fibers
*somatic motor
*somatic sensory fibers
*sympathetic fibers

Answer 30

somatic motor- intercostal muscles
somatic sensory-from skin to thoracic wall
sympathetic-to sweat glands, arrector pili muscles, blood vessels in skin

Question 31

what are the sympathetic targets in the skin?

Answer 31

blood vessels, arrector pili, sweat glands

Question 32

somatic sensory pathway in thoracic wall

Answer 32

starts in lateral horn

then proceeds to ventral root>spinal nerve>ventral ramus>white ramus comm>sympathetic trunk

synapses in paravertebral ganglia

then goes to gray ramus comm and ventral or dorsal rami

ends at body

Question 33

thoracic wall blood supply

Answer 33

thoracic aorta and internal thoracic arteries

Question 34

thoracic wall venous drainage

Answer 34

posterior intercostal veins and anterior intercostal veins

Question 35

thoracotomy

Answer 35

incision through thoracic wall to enter pleural cavity

Question 36

rib retraction

Answer 36

allows procedures performed via single intercostal space

Question 37

median sternotomy

Answer 37

wide access to thoracic cavity (crack chest)

Question 38

thoracic outlet syndrome

Answer 38

-compression of structures exiting the superior thoracic aperture
-costoclavicular syndrom